Hi! I’ve been away for a bit, but this is too shocking not to pass along. I’ve always been a proponent of choosing health care software carefully, but out in British Columbia, they appear to have hit a new low. Apparently, in Nanaimo, the EHR system chosen by the local health authority is SO BAD they have to pay doctors to use it.
Doctors will pay top dollar to use a high-end EMR that improves patient care and streamlines routine tasks, they will begrudgingly accept a second-line system (like the one being flogged by the NBMS) if user fees are subsidized by their peers but, apparently, you really do have to pay people to use one that is truly abysmal.
More thoughtful analysis of the American EMR experience courtesy of the KevinMD.com website.
It is becoming apparent that more and more EMR users are finding themselves trapped with an EMR that they either did not want, or that they signed up for only because of fire sale prices enabled by government subsidization.
Hmmmm… sounds familiar…
The result is that customer satisfaction is in freefall.
Yet more evidence that the New Brunswick approach of “my way or the highway” is wrong.
Read on to find out why, and how we could do things differently here:
As the New Brunswick EMR dream of “One Patient, One Record” continues to unravel and costs skyrocket there is growing recognition outside of the realm of the New Brunswick Medical Society that the key to successful and meaningful use of electronic medical records lies in getting disparate systems to talk to each other. It is abundantly clear that we need a variety of EMR software packages to fit a variety of physician needs, and that these products need to be able to exchange data with a minimum of fuss and bother.
Achieving this might be akin to finding the Holy Grail, at least according to a recent article by Dr. Eric Cadesky of Vancouver, published in the June 2015 edition of “Future Practice.” The analogy fits to a degree, but a better analogy might be finding the Rosetta Stone, the original “interoperability engine.”
The message is clear, and there is a rising tide of voices opposed to the suppression of information sharing as exemplified by the curiously named Data Sharing Agreement between the New Brunswick government and the New Brunswick Medical Society.
Time to step back and rethink the plan. Blindly pursuing a model which relies on a single EMR vendor runs counter to what is best for patients and the medical community. We need interoperability, and the sooner the better. If we are to make any progress toward that goal, we need buy-in on the part of the NBMS and the New Brunswick government.
Local IT company Populus Global Solutions and it’s electronic medical record system is taking the world – or parts of it – by storm. It’s being sold on its own merits to a variety of Caribbean countries and looking to expand into even more countries. It’s a refreshing approach: popular, rapidly implemented, on budget, and on schedule. Most importantly, they don’t rely on secret exclusionary deals to get a leg up on competitors.
In New Brunswick it’s clearly time to rethink our provincial EMR monopoly. Not just because Accreon is bailing out of Velante. Not just because the existing EMR program is costing a fortune. Not just because the uptake remains questionable despite fire-sale prices and high-pressure sales pitches.
We need to reconsider what we are doing with EMRs in New Brunswick because the fundamental concept of an exclusionary monopoly – such as that forged by Velante and the Provincial government – is wrongheaded and lacking in vision.
We don’t need a single EMR vendor jammed down the unwilling gullets of an unwilling clientele. We need choice. We need a product which fits the needs of the customer.
It’s not about profit. It’s not about lining the pockets of IT consultants. It’s about using appropriate technology to improve the health of New Brunswickers.
Congratulations, New Brunswick, 58 percent of your doctors cite lack of “compatibility with other electronic systems” as a barrier to accessing electronic medical records. Coincidentally (or not), we are the only province with an ironically named “Data Sharing Agreement” which severely limits access to patient data for a large proportion of EMR users.
A full 40% of New Brunswick physicians said access to electronic records was “unsatisfactory,” much higher than even Newfoundland, which came in second with 30.7%. Only 4% of New Brunswick doctors said access was “excellent,” ranking us second worst in the country. Only Quebec scored lower with 3.6%.
Time to smarten up and get with the program, New Brunswick. Information silos are NOT helpful. Interoperability is the way of the future.
Abolish the Data Sharing Agreement now!
More information from the latest National Physician Survey is available here: NPS 2014
Canadian Medical Association President Dr. Chris Simpson wrote this excellent commentary for “Future Practice,” the CMA publication which examines issues related to technology and medicine. Clearly he supports the concepts of interoperability between EMR and EHR systems, and finding a good fit between individual physicians and the EMR products currently available.
Have a read. It seems very straightforward.
Unfortunately, New Brunswick remains mired in a regressive single-vendor environment, promoted jointly by the Department of Health and the New Brunswick Medical Society.
New Brunswick remains the only jurisdiction in the country which bans all but one EMR vendor from digitally linking to provincial health information databases. Patients, doctors, and the I.T. industry are all losers in this regrettable and embarrassing morass.
Kudos to Dr. Simpson for his progressive and intelligent approach.
“And then one day you find ten years have got behind you. No one told you when to run. You missed the starting gun.” Pink Floyd – “Time”
As New Brunswick continues to buck the worldwide trend for interoperability between health care information systems it seems appropriate to pause for a moment and consider how long this battle has been going on, and give credit to the early adopters of electronic medical records for recognizing the importance of various electronic systems being able to talk to each other. Not only were early adopters first out of the blocks with new technology, in most cases they paid their own way, recognizing that improved handling of patient records would have important benefits for the their practice, and for the patients for whom they provide services.
Interoperability is the key to the establishment of a healthy EMR industry in New Brunswick.
Flash back to 2004, and this insightful report from the American College of Physicians:
In 2014, everywhere there is progress dismantling information silos in favour of the free exchange of health care information.
Everywhere but here.
The New Brunswick provincial EMR program is stuck in a rut, jealously guarding access to information in order to further the monopolistic ambitions of a single vendor. The proponents of the plan boast of the dozens of doctors who are said to have started to use their EMR product. They have been able to achieve a modicum of success in a variety of ways: 1) handing out taxpayer money to offset their clients’ cost, and 2) forging a secret deal with the Department of Health, in order to cripple the competition.
Does that make for fair competition?
I think not!
Even I could run a faster 100 metres than Usain Bolt, if his ankles were shackled.